Influence of glycosylated hemoglobin on long-term outcomes of patients with acute myocardial infarction treated with primary percutaneous coronary intervention

Objective To evaluate the influence of glycosylated hemoglobin on admission (HbA1c)on long-term outcomes of patients with acute myocardial infarction treated with primary percutaneous coronary intervention. Methods A total of 305 patients with acute ST-segment elevation myocardial infarction (STEMI) received primary percutaneous coronary intervention from Dec 2007 to Dec 2012 were enrolled in this study. HbA1c was measured on admission for all patients. Clinic characteristics、biochemical indicator, death and major adverse cardiac events (MACE) during follow up were recorded. Patients were classified into three groups: group 1(HbA1c≤5.6%, n=85); group 2 (5.7%≤HbA1c≤6.4%, n=117); and group 3 (HbA1c≥6.5%, n=103). Results The patients were followed up for a mean of (1 075±414)days.23 patients (7.5%) died and MACE occurred in 37 patients(12%). MACE rate in one year was higher in group 3 (8.7%) than in group 2 (2.6%) and group 1 (1.2%; both P< 0.05). One-year mortality rate was higher in group 3 (5.8%) than in group 2 (0.9%) and group 1 (0) %, both P< 0.05). Elevated HbA1c (P=0.010) was associated with long-term (more than 1 year)MACE. After multivariate analysis, HbA1c (HR: 1.34, 95%CI: 1.099-1.633, P=0.004) was independently associated with long-term (more than 1 year) mortality. Conclusions HbA1c is an independent predictor of one-year and long-term outcomes in STEMI patients treated with primary percutaneous coronary intervention. Key words: Myocardial infarction; Glycosylated hemoglobin; Outcome